HC Deb 13 February 2004 vol 418 cc273-6W
Mr. Burstow

To ask the Secretary of State for Health if he will estimate the number of trained dentists living in the UK as refugees; and what proportion he estimates are working in the NHS. [151467]

Ms Rosie Winterton

Information is not held centrally on the number of refugees working as dentists in the national health service. We are aware that the British Dental Association and the Refugee Council have a database containing details of 60 dentists who are refugees. These dentists are preparing for the General Dental Council's international qualifying examination (IQE) to become eligible to practise in the United Kingdom. We are considering how dentists with overseas qualifications could be given more support with the additional training they require to take the IQE and equip themselves to practise in the NHS.

Mr. Steen

To ask the Secretary of State for Health if he will break down the funding targeted at primary care trusts where access to NHS dentists is low, announced on 18 September 2003, by(a) region and (b) primary care trust. [151540]

Ms Rosie Winterton

[holding answer 28 January 2004]: On 18 September 2003 we announced new investment totalling £65.2 million for dentistry. This consisted of £35 million capital for dental access and quality, £30 million for dental information technology and £200,000 for developing dental leadership. This was on top of revenue funding we announced in August of £9 million for targeted support on dental access and £1 million for organisation development. We subsequently announced on 25 November further revenue funding of £15 million to support access for patients to a modernised national health service dental service, bringing the total of new funding announced this year for dentistry to £90.2 million.

The £30 million investment in IT will facilitate integration of dental practices with wider NHS information technology systems and will support local contracting. The IT investment and solutions for dentistry consistent with other NHS information technology initiatives are being taken forward within the national programme for IT.

The funding of £200,000 for developing dental leadership is aimed at strategic health authority level to support primary care trusts (PCTs) in delivering the modernisation agenda for dentistry.

The organisational development funds of £1 million are being distributed in line with advice from strategic health authorities (SHAs). They are intended to help PCTs, local dental committees and dentists to prepare for the change in the way dental services are commissioned. £0.3 million has been distributed for 2003–04 and the remaining £0.7 million will be distributed for use in 2004–05.

The balance of £59 million is intended to support dental access and quality as follows: £9 million is for the NHS dentistry support team that has been set up to work with those areas where it is hardest to find a NHS dentist. These funds are being used in a targeted way to support local action plans for improving access to dentistry. The NHS support team has identified 16 PCTs with specific dental access issues. Funding for these PCTs, which are shown in the list, will take into account the challenge faced by the individual PCTs and the potential benefit of the proposals in the dental action plan that each of the challenged PCTs is developing. Draft plans are now starting to arrive. The team allocated £200,000 in 2003–04, and will be increasing the pace of allocations early in 2004–05, based on the plans currently in preparation. £35 million capital funds are to enable PCTs to invest in primary care premises and facilities to improve access and quality. These funds will be distributed on a fair-shares basis at SHA level and then on a targeted basis to PCTs on the advice of the SHAs. The fair shares for SHAs are shown in the table. The bulk of the funds will be spent in 2004–05 to allow SHAs and PCTs to plan for its investment. £15 million revenue funding for 2004–05 to support access will also be allocated on a fair-shares basis at SHA level and, on the advice of the SHA, on a targeted basis to PCTs. The SHA fair shares allocations of these funds are shown in the table.

Guidance for PCTs on commissioning NHS dentistry, including the allocation of £35 million capital and £15 million revenue to support access, quality and choice was issued on 15 January. The guidance makes it clear that access remains a key priority in the run up to the new arrangements for dentistry from April 2005.

PCTs which have been identified for support from the NHS Dentistry Support Team

  • Fareham and Gosport PCT
  • Isle of Wight PCT
  • New Forest PCT
  • West Gloucestershire PCT
  • North East Lincolnshire PCT
  • Scarborough, Whitby and Ryedale PCT
  • Craven, Harrogate and Rural District PCT
  • Northumbria Care Trust
  • Burnley, Pendle and Rossendale PCT
  • Hyndburn and Ribble PCT
  • Blackburn with Darwen PCT
  • Morecambe Bay PCT
  • Shropshire County PCT
  • Telford and Wrekin PCT
  • South West Staffordshire PCT
  • Central Cheshire PCT

Strategic Health Authority Capital Revenue
England 35,000 15,000
Avon, Gloucestershire and Wiltshire 1,396 598
Bedfordshire and Hertfordshire 1,039 446
Birmingham and The Black Country 1,771 761
Cheshire and Merseyside 1,853 796
County Durham and Tees Valley 894 384
Cumbria and Lancashire 1,411 602
Dorset and Somerset 814 349
Essex 1,071 458
Greater Manchester 1,987 852
Hampshire and Isle of Wight 1,148 492
Kent and Medway 1,071 459
Leicestershire, Northamptonshire and Rutland 962 412
Norfolk, Suffolk and Cambridgeshire 1,416 607
North and East Yorkshire and Northern Lincolnshire 1,073 460
North Central London 961 413
North East London 1,297 556
North West London 1,344 575
Northumberland, Tyne and Wear 1,089 466
Shropshire and Staffordshire 988 425
South East London 1,165 499
South West London 863 370
South West Peninsula 1,092 469
South Yorkshire 981 420
Surrey and Sussex 1,689 723
Thames Valley 1,285 550
Trent 1,813 777
West Midlands South 1,013 433
West Yorkshire 1,514 648

Mr. Hancock

To ask the Secretary of State for Health if he will make a statement on progress of Options for Change in improving NHS Dentistry, with particular reference to(a) Portsmouth and (b) South Hampshire. [151997]

Ms Rosie Winterton

We are committed to rebuilding and restoring national health service dentistry to improve oral health. The report, "NHS Dentistry: Options for Change", published in 2002, set out the ideas and principles behind the reform of NHS dentistry. Central to these changes are the aims oflocal commissioning of services offering care which is responsive to local need; moving away from the restrictions of the detailed and inflexible existing fee-for-item system and giving dentists the opportunity to practise more preventive dentistry; improving the patient experience; improving access to NHS dentistry.

New legislation in the Health and Social Care (Community Health and Standards) Act 2003 will enable these changes and will underpin a modernised, high-quality primary dental service, properly integrated with the rest of the NHS. The aim is to deliver better access to services; better working lives for dentists and their teams, better oral health and an improved patient experience. From 1 April 2005, primary care trusts (PCTs) will assume a new responsibility for commissioning dental services supported by the £1.2 billion resources currently held centrally.

The Health and Social Care (Community Health and Standards) Act also provides for the replacement of the existing Dental Practice Board by a new special health authority for England and Wales with a wider remit for modernisation and change. This is likely to happen in 2005. In the meantime, shadow arrangements are in place to work in partnership with the existing Dental Practice Board to lead the modernisation process and provide support to PCTs and dentists to ensure a smooth transition to the new arrangements. Discussions are also on-going with the dental profession on the base contract, which will replace the item of service arrangements.

In Hampshire, each PCT has identified a dental management lead who has been working closely with the strategic health authority dental lead and the Department of Health to prepare dental action plans for the transition to local commissioning of dentistry. In agreement with the Department, arrangements have been made for some dental practices that wish to do so—including one in Portsmouth—to act as pilots for future contracting arrangements.